From the Department of Pediatrics (Drs Hickson and Clayton), School of Law (Dr Clayton), Health Policy Center, Institute for Public Policy Studies (Ms Githens), and Department of Economics (Dr Sloan), Vanderbilt University, Nashville, Tenn.

Design.—Families were interviewed by telephone using a questionnaire that contained structured and open-ended questions.

Participants.—Mothers of infants who had experienced permanent injuries or deaths and had closed malpractice claims in Florida between 1986 and August 1989 were interviewed. Questionnaires were completed by 127 (35%) of a total of 368 such families.

Outcome Measures.—Reasons prompting families to file and families' descriptions of medical events, advice from acquaintances, and the quality of physician-family communication.

Results.—Families volunteered numerous reasons for filing: advised by knowledgeable acquaintances (33% of respondents), recognized cover-up (24%), needed money (24%), recognized that their child would have no future (23%), needed information (20%), and decided to seek revenge or protect others from harm (19%). Over one third of all families indicated that they were told by medical personnel prior to filing that the care provided had caused their children's injuries. Families expressed dissatisfaction with physician-patient communication. Families believed that physicians would not listen (13% of sample), would not talk openly (32%), attempted to mislead them (48%), or did not warn about long-term neurodevelopmental problems (70%).

Conclusion.—Families give many reasons for filing a claim. Obtaining money may not be the only goal for some families who file suit.(JAMA. 1992;267:1359-1363)